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Serology > Syphilis Serology 1 > Flashcards

Syphilis Serology 1 Flashcards

1
Q

What is the causative agent of syphilis?

A

Treponema pallidum

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2
Q

Signs and symptoms associated with the Early Primary stage syphilis

A

Chancre at site

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3
Q

Signs and symptoms associated with the Late Primary Stage of syphilis

A

Chancre healing

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4
Q

Signs and symptoms associated with the Secondary Stage of syphilis

A

Skin rash, mucous membrane lesions

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5
Q

Signs and symptoms associated with the Early Latent Stage of syphilis

A

No symptoms

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6
Q

Signs and symptoms associated with the Late Latent Stage of syphilis

A

No ssmptoms

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7
Q

Signs and symptoms associated with the Tertiary Stage of syphilis

A

Systemic (cardiac, skeletal, CNS)

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8
Q

Darkfield Examination of Syphilis:

- appropriate specimen for testing

A

Only direct exam for treponemes. Collected from lesions (chancres, rash)

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9
Q

Darkfield Examination of Syphilis:

- procedure

A

Sample collected from lesions, and examined by dark field microscopy (looking for motility of treponemes)

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10
Q

Darkfield Examination of Syphilis:

  • appearance of a positive
  • appearance of a negative
A

Positive: Treponemes move in a definite direction using corkscrew or spiraling motility.
Negative: Non-pathogenic ttreponemes move randomly with inchworm style motility

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11
Q

Darkfield Examination of Syphilis:

- stages where this test is helpful

A

Primary and Secondary stages because of collection type (lesions)

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12
Q

Darkfield Examination of Syphilis:

- technical factors that limit the usefulness

A
  • useful only when lesions present
  • cumbersome (warmth, time limit)
  • difficult to tell pathogenic from non-pathogenic
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13
Q

Why are VDRL and RPR called “non-treponemal” tests?

A

Tests are not testing for antibodies against treponemes, only anti-tissue antibodies

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14
Q

What is the definition of cardiolipin

A

(antigen) non nitrogenous phospholipid found in many plant and animal tissues

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15
Q

Definition of reagin

A

non-specific anti-tissue antibodies NOT antibodies agains treponemes

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16
Q

Sensitivity of Non-treponemal tests during early primary stage of syphilis

A

Negative

17
Q

Sensitivity of Non-treponemal tests during late primary stage of syphilis

A

Positive (titers increasing)

18
Q

Sensitivity of Non-treponemal tests during secondary stage of syphilis

A

Postive (titers high)

19
Q

Sensitivity of Non-treponemal tests during early latent stage of syphilis

A

Positive (titers declining)

20
Q

Sensitivity of Non-treponemal tests during late latent stage of syphilis

A

Positive? (titers declining)

21
Q

Sensitivity of Non-treponemal tests during tertiary stage of syphilis

A

50% may revert to negative

22
Q

What diseases may produce falsely positive results in the non-treponema tests for syphilis?

A

Other disease states/conditions have these antibodies (ex. pregnancy) The test can be too sensitive which leads to biological false positives.

23
Q

How are non-treponemall tests used to monitor treatment of syphilis

A

Useful because once treated successfully the disease goes away (you can get it again!) so you can monitor successful treatment

24
Q

How are non-treponemal tests used to identify re-infected with syphilis

A

Reagin antibodies are present in infection and then disappear with treatment making it easy to detect reinfection

25
Q

Meaning of VDRL

A

Veneral Disease Research Laboratory

26
Q

Serologic principle for VDRL

A

flocculation

27
Q

flocculation vs direct agglutination

A

Flocculation causes the antigen substance to be cloudy due to added substances that enhance the visibility of the reaction

28
Q

VDRL

- testing procedure

A

Cardiolipin antigen and patients SERUM mixed on glass microscope slide to detect reagin antibodies
(serum must be heat inactivated for 30 minutes at 56C prior to testing)

29
Q

VDRL

- test results read micro or macroscopically

A

microscopically

30
Q

VDRL

- Appearance of reactive, weakly reactive, and non-reactive controls

A

Reactive: distinctive chunks
Weakly Reactive: smaller chunks
Nonreactive: cloudy

31
Q

Meaning of RPR

A

Rapid Plasma Reagin

32
Q

RPR

- serologic principle

A

flocculation

33
Q

RPR

- procedure

A

uses cardiolipin-lecithen-cholesterol antigen with carbon particles.

34
Q

RPR

- observed micro or macroscopically

A

macroscopically

35
Q

RPR

- appearance of reactive, weakly reactive, and non-reactive controls

A

Reactive: big darker chunks
Weakly Reactive: smaller chunks with hazy background
Nonreactive: clear and/or swirling tail

36
Q

VDRL v.s RPR

- sensitivity, specificity, and ease of performance

A

Have about the same sensitive and specificity for testing serum. RPR is NOT approved for CSF testing.
- easier to do RPR because you have to heat inactivate

37
Q

VDRL v.s. RPR

- significance of a weakly reactive result

A

May be due to prozone with an increased amount of antibody present

38
Q

VDRL and RPR

- further testing for reactive or weakly reactive

A

must be tested quantitatively by the VDRL/RPR test and then confirmed by a treponema antibody detection method

39
Q

What is the only syphilis assay approved for testing spinal fluid?

A

VDRL

Serology (17 decks)

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